Women's Health Community

With all the TV ads for lawsuits from the mesh complications from Pelvic Organ Prolapse (POP) surgery, I'd personally be hesitant to go that route. I know they can sometimes use your own tissue to "fix" the fascia and ligaments but that isn't always possible due to the deterioration of the tissues as well as the surgeon's skills.

Also, if you go the surgical route (mesh or not) why not suspend the uterus as well as the bladder? I never understood the reason for removing the uterus versus just suspending it along with the bladder.

I don't know if you discussed physical therapy but it can make a difference although effectiveness probably depends on degree of prolapse. A pessary may sound like a bother but I know women who say it's no big deal. At least these are non-invasive and still leave the door open for surgery if they don't work...just my thoughts. This link might help - http://www.continence.org.au/pages/prolapse.html.

I don't have much to say on the vaginal estrogen although it can sometimes be helpful for urinary issues. I didn't think there was any connection between vaginal estrogen and cancer. Systemic estrogen has not been shown to increase breast cancer risk despite the HRT scare around 2002.

I'm in the same situation. I am scheduled for a hysterectomy. I'm post menualpausal..Maybe things for us will get better.

Well as you mentioned, all the complications and surgeons skills and a foriegn substance in the body is what concern me. As well as the possible pain with it in while havning sex and having to remove all the time for cleaning etc. Just too many negatives about the pessary for me.
I didn't know they could suspend the uterus, but I'm 54, full menopause, have 2 adult children, 3 grandchildren and a 3 yr old little girl we adopted 2 yrs ago, we're not wanting anymore children. So I really don't need it.
Th name of the cream she gave me is Estrace. Do you know anything about this specific cream? Was it part of the HRT scare you mention? What kind of urinary issues DOES the uterus cream help with?

Are you getting a full or partial hysterectomy?

The uterus isn't just for having babies, menopausal or not. I'd pay big $$$ to get mine back.

A surgical mesh "foreign substance" is more concerning than a pessary that can be removed by you at any time. The mesh becomes "enmeshed" with your bodies' tissues. So if you have complications (including infections), it may be impossible to remove all the mesh. Here's the FDA's Safety Communication on Mesh Complications for POP -
http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm262435.htm
Here's one paragraph - "From 2008 — 2010, the most frequent complications reported to the FDA for surgical mesh devices for POP repair include mesh erosion through the vagina (also called exposure, extrusion or protrusion), pain, infection, bleeding, pain during sexual intercourse (dyspareunia), organ perforation, and urinary problems. There were also reports of recurrent prolapse, neuro-muscular problems, vaginal scarring/shrinkage, and emotional problems. Many of these complications require additional intervention, including medical or surgical treatment and hospitalization."

Estrace vaginal cream was not part of the studies. The studies involved systemic (not local vaginal) estrogen. But the studies showed NO increased risk with estrogen alone.

And as I mentioned before, physical therapy may be an option but it may not even be suggested by your surgeon since he/she won't make anything from it. If you want to try that, you could go through your primary care doctor to get it approved. May be worth doing some reading on the web about it.